NRS 420 Exam 4 V1 | NRS 420 Health
Assessment | Actual Q&A with Rationale
(NRS420 Exam 4) | Grand Canyon
University
1. A nurse is performing a neurological assessment on an older adult client. Which of the
following findings should the nurse identify as expected changes associated with aging?
(Select All That Apply)
A. Decreased sense of smell
B. Slightly slower reflex responses
C. Loss of vibratory sense at the ankle
D. Consistent tremors at rest
E. Decreased muscle strength in the extremities
F. General decline in intellectual ability
Correct Answer: A, B, C, E
Rationale: Aging is associated with a decrease in sensory perception such as smell and
vibratory sense at the distal extremities. Motor responses and reflexes also naturally slow
down as the nervous system undergoes physiological changes over time. However, resting
tremors are indicative of pathology like Parkinson’s disease and intellectual decline is not a
normal part of aging.
,2. When assessing the musculoskeletal system, the nurse asks the patient to move their arm
away from the midline of the body. This movement is documented as:
A. Abduction
B. Adduction
C. Circumduction
D. Pronation
Correct Answer: A
Rationale: Abduction is the movement of a limb away from the midline of the body,
whereas adduction is moving it toward the midline. Circumduction is a circular motion, and
pronation involves turning the forearm so the palm is down. Accurate terminology is
essential for objective musculoskeletal documentation.
3. A nurse is assessing a patient for a possible carpal tunnel syndrome. Which specialized test
should the nurse perform?
A. Phalen test
B. McMurray test
C. Bulge sign
D. Thomas test
Correct Answer: A
, Rationale: The Phalen test involves holding the wrists in acute flexion for 60 seconds to
see if numbness or burning occurs, which suggests carpal tunnel syndrome. The Bulge sign
is used to assess for fluid in the knee, and the McMurray test evaluates for meniscal tears.
The Thomas test is utilized to assess hip flexion contractures.
4. During a neurological examination, the nurse observes the patient’s gait. The patient is
unable to maintain balance while walking heel-to-toe in a straight line. Which area of the
brain is likely affected?
A. Cerebrum
B. Brainstem
C. Basal ganglia
D. Cerebellum
Correct Answer: D
Rationale: The cerebellum is responsible for coordinating voluntary movements,
maintaining posture, and ensuring equilibrium. Problems with tandem walking (heel-to-
toe) indicate cerebellar dysfunction or ataxia. The cerebrum handles higher-order
functions, and the brainstem controls vital life functions like breathing.
5. Which of the following activities are considered Instrumental Activities of Daily Living
(IADLs)? (Select All That Apply)
A. Bathing and grooming
B. Managing finances
Assessment | Actual Q&A with Rationale
(NRS420 Exam 4) | Grand Canyon
University
1. A nurse is performing a neurological assessment on an older adult client. Which of the
following findings should the nurse identify as expected changes associated with aging?
(Select All That Apply)
A. Decreased sense of smell
B. Slightly slower reflex responses
C. Loss of vibratory sense at the ankle
D. Consistent tremors at rest
E. Decreased muscle strength in the extremities
F. General decline in intellectual ability
Correct Answer: A, B, C, E
Rationale: Aging is associated with a decrease in sensory perception such as smell and
vibratory sense at the distal extremities. Motor responses and reflexes also naturally slow
down as the nervous system undergoes physiological changes over time. However, resting
tremors are indicative of pathology like Parkinson’s disease and intellectual decline is not a
normal part of aging.
,2. When assessing the musculoskeletal system, the nurse asks the patient to move their arm
away from the midline of the body. This movement is documented as:
A. Abduction
B. Adduction
C. Circumduction
D. Pronation
Correct Answer: A
Rationale: Abduction is the movement of a limb away from the midline of the body,
whereas adduction is moving it toward the midline. Circumduction is a circular motion, and
pronation involves turning the forearm so the palm is down. Accurate terminology is
essential for objective musculoskeletal documentation.
3. A nurse is assessing a patient for a possible carpal tunnel syndrome. Which specialized test
should the nurse perform?
A. Phalen test
B. McMurray test
C. Bulge sign
D. Thomas test
Correct Answer: A
, Rationale: The Phalen test involves holding the wrists in acute flexion for 60 seconds to
see if numbness or burning occurs, which suggests carpal tunnel syndrome. The Bulge sign
is used to assess for fluid in the knee, and the McMurray test evaluates for meniscal tears.
The Thomas test is utilized to assess hip flexion contractures.
4. During a neurological examination, the nurse observes the patient’s gait. The patient is
unable to maintain balance while walking heel-to-toe in a straight line. Which area of the
brain is likely affected?
A. Cerebrum
B. Brainstem
C. Basal ganglia
D. Cerebellum
Correct Answer: D
Rationale: The cerebellum is responsible for coordinating voluntary movements,
maintaining posture, and ensuring equilibrium. Problems with tandem walking (heel-to-
toe) indicate cerebellar dysfunction or ataxia. The cerebrum handles higher-order
functions, and the brainstem controls vital life functions like breathing.
5. Which of the following activities are considered Instrumental Activities of Daily Living
(IADLs)? (Select All That Apply)
A. Bathing and grooming
B. Managing finances
